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Related Experiment Videos

Screening for hypercoagulable syndromes following stroke.

Cheryl Bushnell1, Larry B Goldstein

  • 1Duke Center for Cerebrovascular Disease, Department of Medicine (Neurology), Duke University Medical Center, Box 2900, Durham, NC 27710, USA. bushn002@mc.duke.edu

Current Atherosclerosis Reports
|June 10, 2003
PubMed
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Screening for thrombophilias in ischemic stroke patients rarely yields results. Careful patient selection, especially for younger individuals with unexplained stroke or a history of venous thrombosis, may improve diagnostic yield, though treatment remains uncertain.

Area of Science:

  • Neurology
  • Hematology
  • Genetics

Background:

  • Ischemic stroke patients often undergo screening for hypercoagulable syndromes (thrombophilias).
  • Thrombophilias, including hereditary and acquired coagulation disorders, are typically linked to venous thrombosis but rarely ischemic stroke.
  • Current screening assays can be unreliable due to factors like acute thrombosis, inflammation, and anticoagulant use.

Purpose of the Study:

  • To evaluate the diagnostic utility of thrombophilia testing in patients with ischemic stroke of unclear etiology.
  • To identify patient subgroups and testing strategies that may improve the diagnostic yield of thrombophilia screening.
  • To review the current understanding of thrombophilias in the context of ischemic stroke.

Main Methods:

  • Review of existing literature on thrombophilia testing in ischemic stroke patients.

Related Experiment Videos

  • Analysis of factors influencing the reliability of thrombophilia assays.
  • Discussion of patient selection criteria for improved diagnostic yield.

    • Main Results:

    • The overall diagnostic yield of thrombophilia tests in unselected ischemic stroke patients is low.
    • Careful selection of younger patients with undetermined stroke causes, history of venous thrombosis, or recurrent miscarriages can enhance diagnostic yield.
    • Established strategies exist to guide patient and test selection for thrombophilia evaluation.

    Conclusions:

    • Thrombophilia testing has a limited role in unselected ischemic stroke patients.
    • Targeted screening in specific patient populations may increase diagnostic value.
    • The optimal secondary prevention strategies for most thrombophilias remain undetermined.